Sochacki and colleagues used publicly available internet sources to identify NFL players who underwent forearm fracture open reduction and internal fixation (ORIF) and sought to determine whether these players were able to return to sport (RTS) in the NFL and how their performance was impacted by the surgery. They found 36 NFL players who underwent this procedure from 1987 to 2016, of whom 33 (92%) returned to NFL competition at an average of 152 days postoperatively. The injury was most common in defensive backs (21 of 36, 58%). Postoperative performance after forearm fracture ORIF did not differ from pre-injury performance nor from performance of matched controls. Nevertheless, players’ careers were an average of 1-year shorter compared to matched controls.
This study confirms the high RTS rate for forearm fracture ORIF from a prior report by Mai and colleagues, but extends these findings to evaluate not just RTS, but also more detailed analysis of player performance. Limitations of this study include potential selection and reporting biases related to the strategy of identifying these injuries via publicly available internet sources. In addition, this methodology makes it impossible to determine many parameters of interest to the orthopedic surgeon including specific fracture characteristics (eg, one vs. both bone, fracture pattern, comminution, open injury, associated neurovascular injury, dislocation), surgical technique and approach, patient-reported outcome measures, postoperative radiographic outcomes and complications.
The take-home message of the study is that forearm fracture ORIF is an uncommon procedure in NFL players but that players have high rates of RTS and no change in their performance compared to before injury, but a 1-year shorter career compared to other players.
Gregory L. Cvetanovich, MD
Rush University Medical Center
Disclosures: Cvetanovich reports no relevant financial disclosures.